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Retinoids in Antiaging Therapy
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Zehra Aşiran Serdar, Ezgi Aktaş Karabay
Tazarotene, an acetylenic retinoid, is used mainly in the treatment of psoriasis and acne. Tazarotene is a prodrug that is rapidly metabolized to its active form, tazarotenic acid. Although tazarotene is a member of the retinoid family, it presents a different receptor selectivity pattern from tretinoin. Tretinoin directly activates all RAR subtypes, while it indirectly stimulates RXRs; tazarotenic acid selectively binds to RAR-β and RAR-γ but not RXRs (1).
Basic dermatology in children and adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Kalyani Marathe, Kathleen Ellison
When instituting new acne therapy, it is of utmost importance to counsel patients that 2–3 months of consistent use is necessary to determine the efficacy of any therapeutic regimen. Topical treatments are usually effective in patients with primarily comedonal acne. All patients with acne should be started on a topical retinoid such as adapalene, tretinoin, or tazarotene. Topical retinoids normalize the abnormal follicular keratinization that contributes to acne and have anti-inflammatory properties. Patients should be warned of potential irritation as well as the possibility of a pustular flare during the first month of use. Adapalene 0.1% has become available over the counter in the United States, but the other topical retinoids require a prescription. It is important to note that tazarotene is a topical medication that is contraindicated with pregnancy, and it requires simultaneous contraception. Azelaic acid, a comedolytic dicarboxylic acid that has modest activity against P. acnes, can be prescribed during pregnancy, as it has minimal systemic absorption, and is, therefore, the safest comedolytic to use during pregnancy. Azelaic acid is also helpful as an adjunct to acne therapy in darker-skinned individuals who exhibit postinflammatory hyperpigmentation, as hypopigmentation can be a side effect of this medication.33
Skin disorders
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
Elizabeth Bardolph, Richard Ashton
Tazarotene is a new topical retinoid for use in moderate plaque psoriasis. Systemic absorption of the active metabolite is minimal.19 As with other retinoids, tazarotene is contraindicated in pregnancy. It is also contraindicated in breastfeeding.
Dermal sensitization, safety, tolerability, and patient preference of tazarotene 0.045% lotion from five clinical trials
Published in Journal of Dermatological Treatment, 2022
Leon H. Kircik, Lawrence Green, Eric Guenin, Waleed Khalid, Binu Alexander
In the phase-2 study, all assessments showed similar improvements after 12 weeks of treatment with both tazarotene lotion and combined vehicle (cream/lotion). Erythema, scaling, and hyperpigmentation showed the greatest numerical improvements, with a higher percentage of participants reporting none at week 12 versus baseline (Figure 2). No more than 2 (3%) participants in either group experienced a severe sign or symptom at any week. Results were generally similar for the pooled phase-3 studies. Most assessments were graded as none or mild in severity and no more than 4 (∼0.5%) participants in any treatment group experienced a severe sign or symptom, nearly all of which occurred during the first 4 weeks of treatment. In tazarotene-treated participants across all studies, temporary worsening (transient increase in mean scores) was observed for scaling, burning, and stinging at week 2 and decreased over time; slight transient increases in erythema and itching were also observed in the pooled phase-3 studies (data not shown).
Safety considerations with combination therapies for psoriasis
Published in Expert Opinion on Drug Safety, 2020
The efficacy of the combination therapy of superpotent topical corticosteroids and the topical vitamin A derivative tazarotene has been well studied [21–26]. In a double-blind, randomized, parallel group study, patients were treated with an initial open-label treatment phase consisting of tazarotene 0.1% gel plus clobetasol propionate 0.05% ointment for 6 weeks. The frequency of application of both medications was slowly weaned off over these 6 weeks. In the subsequent double-blind maintenance phase, patients were randomized to receive one of the following three maintenance regimens for 20 weeks: tazarotene/clobetasol, tazarotene/vehicle, and vehicle. The combination of tazarotene and clobetasol during the initial treatment phase showed marked global improvement of psoriasis, and the maintenance regimen of tazarotene/clobetasol was superior to tazarotene/vehicle and vehicle [21]. The addition of a topical corticosteroid to tazarotene appears to reduce erythema of psoriasis and enhances the speed at which improvement is observed while also reducing tazarotene’s local side effects of irritation [26]. The use of tazarotene with a topical corticosteroid can also be beneficial to reduce overall exposure to the steroids and, consequently, reduce steroid-induced epidermal atrophy in normal skin [27].
Psoriasis-associated cutaneous pain: etiology, assessment, impact, and management
Published in Journal of Dermatological Treatment, 2019
Deeti J. Pithadia, Kelly A. Reynolds, Erica B. Lee, Jashin J. Wu
Many standard therapies for psoriasis have been found to have long-term efficacy in alleviating chronic skin pain. Calcitriol and calcipotriol are commonly utilized to target psoriatic plaques, due to their inhibitory effect of keratinocyte proliferation (38). They have been reported to significantly decrease cutaneous stinging and burning sensations as well as perilesional erythema and edema (39). In two phase III trials, apremilast led to an 80% improvement in skin discomfort and pain after just one week of use. This effect lasted consistently through the end of the 32-week trials and correlated with quality of life improvement (40). Apremilast combined with narrowband UVB therapy has been shown to result in a 77% mean improvement in pain measured over 12 weeks in 29 patients. However, first-degree burns were found in 38% of patients and one patient experienced second-degree burns (41). This emphasizes the importance of considering elevated photosensitivity in psoriasis patients when considering phototherapy adjuncts. Topical coal tar and tazarotene may also exacerbate skin pain, irritation, and discomfort (42).